Vaginal Discharge

Question 1

Components of normal vaginal discharge

Answer 1

Cervical mucus
Vaginal fluid (trans usage from vaginal epithelium)
Bacteria
Shedding of vaginal and cervical cells
Skene’s and bartholin’s glands secretions

Question 2

Aetiology of BV

Answer 2

Normal pH of vagina <4.5
Rise in pH (can result from douching) the normal balance of vaginal flora is disrupted and this results in a disproportionate replacement of lactobacilli with anaerobes

Question 3

Types of bacteria with BV

Answer 3

Gardnerella vaginalis
Bacteroides
Prevotella
Peptostreptococcus

Question 4

Amsel’s diagnostic criteria to confirm BV

Answer 4

Elevated vaginal pH (>4.5)
The presence of white adherent discharge that contains
Numerous exfoliated epithelial cells with bacteria (gram-variable rods) attached to their surface (clue cells) that
Has a characteristic fishy odor, especially when 10% KOH is added (whiff test)